Radial Tunnel Syndrome: A Surgeon's Perspective

Radial tunnel syndrome is relatively uncommon but is an important cause of lateral forearm pain. Clinical examination is a crucial part of the diagnosis with weakness of finger extension and local tenderness at the ligament of Frohse being the two most important. Surgical release of the superficial head of the supinator muscle and the division of the ligament of Frohse is usually successful in relieving the symptoms. Radial tunnel syndrome (supinator syndrome) can coexist with tennis elbow and cervical brachial neuritis. The diagnosis must be considered when there is atypical tennis elbow or de Quervain's tenovaginitis stenosans resistant to normal treatment. The relationship between radial tunnel syndrome and work remains unclear but repeated supination of the forearm combined with extension of the elbow appears to aggravate the symptoms. There is no scientific evidence to suggest a direct causal relationship between work practices and radial tunnel syndrome.